Centre of Research and Education in General Practice, Department of Public Health, University of Copenhagen, Faculty of Health Sciences, Copenhagen, Denmark.
Spine Unit, Department of Orthopedic Surgery, Zealand University Hospital, Køge, Denmark.
Spine (Phila Pa 1976). 2020 Aug 15;45(16):1143-1150. doi: 10.1097/BRS.0000000000003486.
Registry-based repeated-measures psychometric validation of the Danish Oswestry Disability Index (ODI).
The goal was to use classical and modern psychometric validation methods to assess the measurement properties and the minimally clinical important difference (MCID) of the ODI in a Danish cohort of patients with chronic low back pain being treated with spinal surgery.
Scores for the ODI, EQ-5D, SF-36, leg pain, back pain, and a general rating of pain item from 800 patients with chronic low back pain were extracted from the National Danish Spine Registry (DaneSpine) at baseline and 1-year postspine surgery.
Confirmatory factor analysis and item response theory (IRT) models were used to assess the psychometric properties of the ODI. MCID was also calculated based on generic legacy PROMs (EQ-5D and SF-36) and follow-up pain scores.
While ODI did not fit a Rasch model, adequate fit to a confirmatory factor analysis and a two-parameter item response theory model was found when accounting for differential item functioning across diagnostic subgroups (degenerative spondylolisthesis, spondylosis, spinal stenosis, and herniated intervertebral disc). In addition, each group exhibited substantially different MCID values.
The Danish version of the ODI is valid and responsive, but only within each of the four major diagnosis subgroups: degenerative spondylolisthesis, spondylosis, spinal stenosis, and herniated intervertebral disc.
基于丹麦 Oswestry 残疾指数（ODI）的注册表重复测量心理计量验证。
使用经典和现代心理计量验证方法，评估 ODI 在接受脊柱手术治疗的慢性下腰痛丹麦患者队列中的测量特性和最小临床重要差异（MCID）。
基线和脊柱手术后 1 年，从国家丹麦脊柱登记处（DaneSpine）提取了 800 例慢性下腰痛患者的 ODI、EQ-5D、SF-36、腿部疼痛、背部疼痛和一般疼痛评分的项目。
使用验证性因子分析和项目反应理论（IRT）模型评估 ODI 的心理计量特性。还根据通用传统 PROM（EQ-5D 和 SF-36）和随访疼痛评分计算 MCID。
虽然 ODI 不符合 Rasch 模型，但在考虑诊断亚组（退行性脊椎滑脱、脊椎病、椎管狭窄和椎间盘突出）的差异项目功能时，对验证性因子分析和双参数项目反应理论模型的拟合良好。此外，每个组都表现出明显不同的 MCID 值。
丹麦版 ODI 是有效且敏感的，但仅在四个主要诊断亚组内有效：退行性脊椎滑脱、脊椎病、椎管狭窄和椎间盘突出。
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